Postpartum depression (PPD): Everything you need to know!

Postpartum depression is not to be confused with "baby blues". In fact, the latter generally appears in the three days following childbirth and disappears within two weeks. It affects 30 to 80% of women. a feeling of depression, intense fatigue and a desire to cry for no reason. It is said to be a physiological reaction marking the end of physical and mental stress. It can also occur after sports and intellectual competitions.

Therefore, unlike post-partum depression, baby blues is therefore not an illness. Post-natal depression is longer and marked by a more severe clinical state. 

What is postpartum depression? 

When the symptoms of the baby blues continue beyond one to two weeks, it may be postpartum depression.  

However, postpartum depression usually begins 6 to 8 weeks after childbirth. This spontaneous depression lasts from 6 months to 1 year. 

The symptoms of postpartum depression are as follows: 

• Intense and lasting sadness,
• A loss of zest for life and interest in everyday activities. In postpartum depression, there is also a feeling of guilt and incompetence in caring for the baby, 
• Intense fatigue, usually first thing in the morning,
• High anxiety about the health and safety of the baby.

According to Dr. Michel Dugnat, a child psychiatrist at Sainte-Marguerite Hospital in Marseille, women suffering from post-natal depression rarely seek help, feeling guilty for not experiencing the long-awaited maternal happiness. 

What causes postpartum depression?

It is difficult to predict who will be affected by postpartum depression.

However, some people seem to be more vulnerable to it, particularly mothers who have already experienced an episode of depression before or during their pregnancy. 

It can also occur after a difficult birth, when the pregnancy was undesired or when the baby was born premature, underweight or had to be hospitalized. 

Certain socio-economic factors can also contribute to postnatal depression. These may include problems in the parental relationship, isolation of the mother, a period of unemployment, etc. 

In addition, a recent stressful event, such as a bereavement or a break-up, can have an influence on the onset of postpartum depression. 

How is postpartum depression diagnosed?

In order to diagnose postpartum depression, the following is required 

• That the mother experiences at least two of the symptoms described above,
• That these symptoms are almost permanently for a period of more than two weeks,
• And that they cause significant discomfort, on a daily basis, since the birth of the baby.

Screening should be done as early as possible, between the 6th and 8th week after delivery, so that the disharmonious spiral between mother and child can be brought to a rapid end.

How is postpartum depression treated?

When post-natal depression is severe, treatment should be provided as soon as possible.  

There are different ways of treating it:

Psychotherapy

Joint therapy of mother and child with a psychotherapist is the best solution. These therapies usually last 8 to 10 weeks. During each session, the therapist will try to defuse the conflict between the mother and the child. This often involves deep conversation and examination of possible conflicts or trauma in the mother's past or current relationships. Therapy helps to restore the mother-child relationship. 

Mother-Baby Units (MBUs) and inpatient support programs

Some hospitals and birth centers have mother-baby units, where mothers may be hospitalized full time or just for the day. In these units, a team of caregivers made up of child psychiatrists, psychologists and nurses work together to enable mothers to regain their self-confidence and create a bond with their child that is fundamental for their development during the first few months of life.

Outpatient programs

Some hospitals and birth centers have set up a system of outpatient, home-based psychological support programs for when the mother is unable to travel, but also to make up for the lack of places in these units.

The recovery rate from postpartum depression is high. Most mothers see an improvement within a few months with the help of appropriate care and support. 

To find out more about in- and outpatient perinatal psychological support programs in the US, feel free to consult the Postpartum Support International website here.

What are the consequences for the baby?

Postpartum depression has an influence on the psycho-emotional and behavioral development of the child. They may show signs of irritability or anxiety with difficulty in detaching from their mother and fear of others.  

In addition, these children may also show delays in learning skills such as language or motor skills. 

Some infants also suffer from digestive problems or sleep issues. 

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